The effect of coenzyme Q10 supplementation on in vitro fertilization outcomes in infertile patients with polycystic ovary syndrome

Background Polycystic ovary syndrome (PCOS) is a leading cause of anovulatory infertility, but evidence regarding coenzyme Q10 (CoQ10) supplementation remains limited and inconsistent. Aim To evaluate associations between pre-IVF CoQ10 supplementation and embryological and reproductive outcomes in women with PCOS. Methods This retrospective cohort included 154 women receiving CoQ10 (100 mg/day for four weeks before IVF; n = 75) or no CoQ10 ( n = 79), as documented in medical records. Embryological and reproductive outcomes were compared, and logistic regression analyses adjusted for age and BMI. Summary Median age was 27 years (IQR, 24–30) in both groups. Body weight was higher with CoQ10 [74 (64–86) vs. 68 (60–80) kg; p = 0.029], whereas BMI did not differ. CoQ10 recipients had higher median MII oocyte counts [18 (12–22) vs. 12 (10–16)], and 2PN oocyte counts [15 (11–20) vs. 10 (8–13); both p < 0.001]. Both medians were 50.0% higher with CoQ10. Pregnancy occurrence was 56.0% versus 30.4% (OR = 2.92, 95% CI: 1.50–5.65), clinical pregnancy was 46.7% versus 16.5% (OR = 4.44, 95% CI: 2.10–9.39), and live birth was 30.7% versus 6.3% (OR = 6.55, 95% CI: 2.34–18.34). Absolute between-group differences were 25.6, 30.2, and 24.4 percentage points, respectively. After adjustment, CoQ10 remained associated with pregnancy occurrence (aOR = 3.01, 95% CI: 1.54–5.90), clinical pregnancy (aOR = 4.82, 95% CI: 2.24–10.36), and live birth (aOR = 6.86, 95% CI: 2.42–19.47; all p ≤ 0.001). Pre-IVF CoQ10 supplementation was associated with better embryological and reproductive outcomes in this cohort. Given the retrospective, non-randomized design, prospective randomized trials are required to confirm efficacy and mechanisms. Selection bias, confounding by indication, and residual confounding therefore cannot be excluded.